Driving While Bipolar

There was a demo of a video car racing game at the mall the other day and I became fascinated by the reactions of the people who were trying it out. I stayed around for a couple of hours and did an informal study of the phenomenon.

I watched almost 100 people drive into walls and other cars and asked 25 of them what they thought was the reason for so many crashes. Almost to a person, it was the fault of the car. Although they sat in seats that were identical to those in a race car, they said it was too twitchy, loose in the corners, and was nothing like driving a real car.

I was ready to conclude that the game was not very good when a man came along who drove incredibly fast without crashing at all. I asked him his secret and he said that he had taken driving lessons at a race track and practiced often in a real race car. He concluded that the game was very realistic and those who thought otherwise were trying to compare it to a normal car. He said the problem is they don't know how to drive and the game is not at fault.

If you took the same 100 people to a race track they would all end up in a wreck. It would be pretty absurd to conclude that it is the fault of the car, but most people make a similar conclusion about bipolar and get upset when someone like myself challenges the assumptions. We blame the vehicle (in this case the brain) and "prove" it is defective because it works differently than "normal" people.

I have been teaching people to drive while bipolar (figuratively) for about ten years now, and see a huge difference in those who have had training and practice compared to those who continue to blame the condition for the way they handle it. Like the skilled race car driver, my conclusion is the lack of training is the problem, not the condition itself.

"Wait a minute," you might say, "we have all kinds of training for depression and bipolar." If you think about it, the only training we have is how to put on the brakes and park our brains in the garage. The current standard of care as defined by the National Institute of Mental Health (NIMH) is to minimize symptoms with the ultimate goal of removing them altogether.

The NIMH did a multi-year study called STEP-BD. Included in their research was an analysis of recovery "defined as having only two symptoms of the disorder for a period of at least 8 weeks, during the 2-year follow-up period." Although their definition is very specific as regards time range and number of symptoms, you will find that no matter where you look the definition of recovery has removal of symptoms as a central element.

There are countless studies that "prove" bipolar and depression are illnesses, but none of them have studied people who know how to drive. The conclusions are on par with the people who think the video game is at fault. They take people with no training for anything but making it go away and watch them drive off a cliff every time the symptoms return.

Dr. Larry Davidson, one of the foremost authorities of recovery in the mental health field, defines recovery as: "being 'in' recovery—even while they remain disabled;" "being 'in' recovery despite the presence of an enduring mental illness;" and "the ability to live a fulfilling and productive life despite a disability." We are being sold a solution that says "make the best of a horrible situation" or "try to make it go away" when many of us have found the situation to be perfectly fine once we learn how to "drive" properly. We call it Bipolar IN Order.

Unfortunately, the STEP-BD study mentioned earlier concludes with, "according to the researchers, these results indicate that in spite of modern, evidence-based treatment, bipolar disorder remains a highly recurrent, predominantly depressive illness." "Recovery" is not a permanent condition; it is a temporary condition with a high probability that the symptoms will return, precipitating another Crisis.

The STEP-BD study proves that it does not work, yet they conclude that "this finding may indicate that complete symptomatic remission, i.e, the absence of all symptoms, should be the goal of treatment, as it is in non-bipolar, major depression." Albert Einstein said that the definition of insanity is doing the same thing over and over again and expecting different results. It is amazing that modern day researchers are living up to Einstein's definition while looking for a solution to the problem of mental illness.

It is time for us to acknowledge that many of us have learned how to drive WHILE bipolar and start focusing on what we do instead of trying to make it go away. In what ways have you been able to drive while bipolar or depressed where you used to crash? What have you done to learn to drive during high and low periods instead of making them go away?

Larry Davidson PhD, "Remission and Recovery in Schizophrenia: Practitioner and Patient Perspectives," and "Personal Accounts: Us and Them;" along with his book "Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia."

My best efforts seem to work, mostly, when I know I'm about to crash into a depression. If I hit bottom before I realize what's happening, I rarely can pull myself out if it. I think this is generally due to the fact that in those dark days I have no desire to pull out of it. However, the more I learn about BPD and how to 'drive' it, the more I believe I could pull myself out of it once I learn to drive well. Right now, the things that work to keep me from going down are exercise, healthy eating, my faith, music (anything that is upbeat and fast; including & especially worship / faith music), talking to friends, keeping busy on something productive, spending time with my pets, getting out in public (even if that's just to go to the mall for a while).

For maina - to come down, or to avoid going too high, I haven't figured out things that are guaranteed to work. I think this is simply because when I'm in a mania, I don't particularly want to come down (much like the depression, only in reverse). I like the way I feel during those times. It helps a lot, though, just to force myself to sit down and relax (even when I don't want to). Also, putting on some soft music, or to take a hot bath with some candles lit generally helps a great deal. Also, I try to keep reminding myself over and over through the day "Relax. Stay calm. Don't get too excited." Then I just do a few deep breathing exercises to force myself to relax a little.

The healthy eating is a really big point. There was a time when I couldn't take care of myself much of the time. I lived with a physically disabled boyfriend and he took care of me, instead of the other way around. My life and my mood swings drastically improved when I changed my life to a healthy living lifestyle. I lost a lot of weight, I started exercising regularly; and I changed my diet. The food issues, I discovered only through extensive tracking of a variety of things in my life for a few years. Eventually I made a connection between my mood swings and certain food items I was eating. I discovered what I now call "trigger foods"; that is, things that trigger a bad episode. For example, almost exactly 20 minutes after I eat a processed cheese slice I will be depressed to the point that I don't think life is worth living. Any kind of artificial or substitute sweeteners will cause a depressive episode as well as extreme 'foggy brain' for a couple days. I get the same reaction from eating fat-free items, such as yoghurt. I've learned that my life is much improved by cutting out these items. So much that now I am able to live alone and have a productive life, where as I couldn't do that before. I also try to stay away from white flour products and processed foods. In addition to these things, I try to eat more of other things that are said to help with depression. Things like salmon, pro-biotic yoghurt (not the fat free kind), blueberries, raspberries, spinach, whole grain breads.

Also, part of my healthy living lifestyle was incorporating habits of Positive Affirmations. I try to focus on positive things as much as possible. I have index cards with positive affirmations and bible verses written on them. I also keep things like my Facebook page filled with groups and fan pages that have positive things popping up all the time. I block out the things I feel are negative or that bother me. I set out to 'retrain the natural negative programming' that seemed to be the basic 'operating system' of my mind. It's a long, hard and extremely difficult process; but it's working. Granted there are still days when I struggle with it a lot; even fail completely and the negative thinking comes back. But, it never stays once I focus on positive thinking. It helps to bring my mood back up when I need it to; and often to keep it from going down.

Having regular practices such as journalling, and having a routine quiet time for spirituality and mediation in the mornings also helps a lot.

Oh, and another thing that I know many scientints don't necessarily believe in, but I have found there to be a pattern with is moon cycles. During the full and new moon times of the month, my mood swings are just crazy. Unfortunately there's not much I can do to change the moon. :-)

I just found you, Tom! Thank you for your work, and for your liberating words.

On this topic of 'driving,' I have found (after 15 years of diagnosis) that many of the things Carley has mentioned are true for me, as well. I also, in particular, find much comfort in pursuing my faith in active ways -- meditation, prayer and dream journaling, and art journaling (which I will discuss in a moment).

The most important things that I have embraced, however, are attitudinal. For instance, 1) stopping the habit of saying that 'I am bipolar,' and replacing it with 'I have bipolar,' and 2) celebrating the gifts which I have received as a result of having bipolar.

The first is a subtle distinction, perhaps, but I got tired of being defined by the label of illness. I am not an illness. I am a person with a specific condition -- one which I can decide to embrace or reject. I believe that we are all uniquely made, and my mood swings are a part of my uniqueness.

The second is mind-blowing for me. I remember, before accepting a medication regime 15 years ago, mourning the loss of such brilliant individuals, who most probably had bipolar, as Virginia Woolf and Vincent van Gogh. How much richer would the world be, I wondered, if their uniqueness had been accepted instead of marginalized, and they had lived longer? How much richer would the world be if we embraced our 'madness' instead of rejecting those who are different? While I do still mourn the losses such as these, I realized, too, that I could still be my unique self, even on medication. I am still gifted. I am still capable of doing marvelous things. Frankly, it took awhile to come out of the medication-induced fog enough to embrace myself fully and to begin to live to my potential, but my determination not to be neutered eventually won out, and I'm glad I made the decision I did. Life is much richer now than it ever has been, largely because I don't take much for granted anymore.

So, my attitude is probably the largest part of my healing-of-self. There are, however, certain activities which I pursue (or avoid) which foster balance for me. I will give just one example of each here.

I have discovered, much to my surprise, that visual art is very healing for me. I used to think I didn't have an artistic bone in my body. (My artistic pursuits, formerly, were writing and music.) About three years ago, however, I followed the example of a dear friend and began to create collages. This has led to work in many different styles and media, and I have learned that emotional/psychological/spiritual expression through art is enormously freeing for me. I am learning and experimenting every day, but one of the richest of my activities is keeping a daily art journal, where I record everything I'm feeling and experiencing at any given moment. I have journaled as a writer for years, but expressing these same feelings (and working through these same dilemmas) through the means of visual art is even more effective, as I get out of my head center and into my heart and gut centers. Visually expressing my joys, my stressors, and my confusions (which used to lead to mood swings) is a powerful means of processing and mediation for me.

In terms of avoidance, I have learned that there are certain inter-personal situations that are simply toxic for me. As a natural leader and innovator, I still cannot allow myself to be drawn into leadership positions within large organizations or groups. The time- and energy-demands and the politics there are deadly for me. Rather, I pursue the use of my gifts in one-on-one settings, and this brings me immense satisfaction and fulfillment. For instance, rather than becoming a pastor (my pre-diagnosis goal), I have become a spiritual director. And instead of working in a corporate or office environment, or volunteering my time with a large organization, I make a modest living as a home organizational consultant, working with individuals very effectively.

I could go on, but this is long enough. Your words have, honestly, struck a real chord with me, and have opened up my eyes to the ways that I am living a positive, fulfilling life now, rather than one circumscribed by a sense of victimhood and limitation. Thank you! I will be following you from here on out.

Hi Laura,
Thank you for your kind words and for sharing such an inspirational story. Virginia Woolf and Vincent van Gogh are two of my favorites. I once had my hair done like van Gogh's paintings and there is a picture of me in front of the painting on our facebook page - http://www.facebook.com/bipolaradvantage